| NPI | 1366440471 |
|---|---|
| Former Name | CONNIE KAY STUMP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 74) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WY 09) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2015-09-10 |